scholarly journals Baseline Quantitative Computed Tomography Measures of Skeletal Muscle Adiposity and Lung Function Trajectory in the Severe Asthma Research Program

Author(s):  
M.C. Tattersall ◽  
N. Tsuchiya ◽  
D.G. Benson ◽  
K.E. Lee ◽  
C. Korcarz ◽  
...  
Diagnostics ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. 33 ◽  
Author(s):  
Joshua Gawlitza ◽  
Timo Sturm ◽  
Kai Spohrer ◽  
Thomas Henzler ◽  
Ibrahim Akin ◽  
...  

Introduction: Quantitative computed tomography (qCT) is an emergent technique for diagnostics and research in patients with chronic obstructive pulmonary disease (COPD). qCT parameters demonstrate a correlation with pulmonary function tests and symptoms. However, qCT only provides anatomical, not functional, information. We evaluated five distinct, partial-machine learning-based mathematical models to predict lung function parameters from qCT values in comparison with pulmonary function tests. Methods: 75 patients with diagnosed COPD underwent body plethysmography and a dose-optimized qCT examination on a third-generation, dual-source CT with inspiration and expiration. Delta values (inspiration—expiration) were calculated afterwards. Four parameters were quantified: mean lung density, lung volume low-attenuated volume, and full width at half maximum. Five models were evaluated for best prediction: average prediction, median prediction, k-nearest neighbours (kNN), gradient boosting, and multilayer perceptron. Results: The lowest mean relative error (MRE) was calculated for the kNN model with 16%. Similar low MREs were found for polynomial regression as well as gradient boosting-based prediction. Other models led to higher MREs and thereby worse predictive performance. Beyond the sole MRE, distinct differences in prediction performance, dependent on the initial dataset (expiration, inspiration, delta), were found. Conclusion: Different, partially machine learning-based models allow the prediction of lung function values from static qCT parameters within a reasonable margin of error. Therefore, qCT parameters may contain more information than we currently utilize and can potentially augment standard functional lung testing.


2015 ◽  
Vol 191 (1) ◽  
pp. 107-110 ◽  
Author(s):  
Sumit Gupta ◽  
Ruth Hartley ◽  
Amisha Singapuri ◽  
Beverly Hargadon ◽  
William Monteiro ◽  
...  

2021 ◽  
Author(s):  
Sujeong Kim ◽  
Sanghun Choi ◽  
Taewoo Kim ◽  
Kwang Nam Jin ◽  
Sang-Heon Cho ◽  
...  

Abstract Background: Asthma comprises heterogeneous inflammatory airway disorders whose classification has not been established. Quantitative computed tomography (QCT) methods can differentiate lung disease using accurate assessment of location, extent, and severity of the disease. This study aimed to identify heterogeneous asthmatic groups by QCT metrics of airway and parenchymal structure, which is associated with radiologists’ visual analysis and bronchodilator responses in a prospective design.Methods: Using the input from QCT-based metrics, including hydraulic diameter (Dh), luminal wall thickness (WT), functional small airway disease (fSAD), and emphysematous lung (Emph), a cluster analysis was performed and compared with grouping based on site of airway involvement and remodeling evaluated by radiologists.Results: 61 asthmatics were grouped into four clusters with different clinical severities. From C1 to C4, more severe lung function deterioration, higher fixed obstruction rate, and more frequent asthma exacerbation in 5-year follow-up were observed. C1 presented non-severe asthma with increased WT, Dh of proximal airways, and fSAD. C2 was mixed with non-severe and severe asthma, which had reserved bronchodilator responses of proximal airways. C3 and C4 presented severe asthmatics that exhibited reduced Dh of proximal airway and its bronchodilator responsiveness; C3 was severe allergic asthma without fSAD, while C4 was ex-smokers with significantly high fSAD% and Emph%. These clusters were correlated with the grouping by radiologists and their clinical outcomes.Conclusions: Four QCT imaging-based clusters with distinct structural and functional changes in proximal and small airways can stratify heterogeneous asthmatics and may serve as complementary tools for predicting future asthma outcomes.


2020 ◽  
Author(s):  
Fabio S. Aguiar ◽  
André S. Melo ◽  
Ana Maria Silva Araújo ◽  
Alexandre Pinto Cardoso ◽  
Sergio A. Lopes de Souza ◽  
...  

Abstract Background: Despite recent advances in understanding its pathophysiology and development of novel therapies, asthma remains a serious public health issue worldwide. Combination therapy with inhaled corticosteroids and long-acting β2-adrenoceptor agonists results in disease control for many patients, but those who exhibit severe asthma are often unresponsive to conventional treatment, experiencing worse quality of life, frequent exacerbations, and increasing healthcare costs. Bone marrow-derived mononuclear cell (BMMC) transplantation has been shown to reduce airway inflammation and remodeling and improve lung function in experimental models of allergic asthma. However, to date, no study has evaluated the therapeutic effects of BMMCs in patients with severe asthma. Methods: This is a case series of three patients who presented with severe asthma unresponsive to conventional therapy and omalizumab. All received a single intravenous dose of autologous BMMCs (2×107) and were periodically evaluated for 1 year after the procedure. Endpoint assessments included physical examination; quality of life questionnaires; imaging (computed tomography, single-photon emission computed tomography, and ventilation/perfusion scan); lung function tests; and a 6-min walk test.Results: All patients completed the follow-up protocol. No serious adverse events attributable to BMMC transplantation were observed during or after the procedure. Lung function remained stable throughout. A slight increase in ventilation of the right lung was observed on day 120 after BMMC transplantation in one patient. All three patients reported improvement in quality of life in the early post-procedure course. Conclusions: This paper is the first to describe the effects of BMMC therapy in patients with severe asthma, providing a basis for subsequent trials to assess efficacy.


Author(s):  
Gregory A. Hawkins ◽  
Mac B. Robinson ◽  
Wendy Moore ◽  
Annette Hastie ◽  
Rodolfo M. Pascual ◽  
...  

2014 ◽  
Vol 44 (5) ◽  
pp. 1188-1198 ◽  
Author(s):  
Matthew Maddocks ◽  
Dinesh Shrikrishna ◽  
Simone Vitoriano ◽  
Samantha A. Natanek ◽  
Rebecca J. Tanner ◽  
...  

Quadriceps muscle phenotype varies widely between patients with chronic obstructive pulmonary disease (COPD) and cannot be determined without muscle biopsy. We hypothesised that measures of skeletal muscle adiposity could provide noninvasive biomarkers of muscle quality in this population.In 101 patients and 10 age-matched healthy controls, mid-thigh cross-sectional area, percentage intramuscular fat and skeletal muscle attenuation were calculated using computed tomography images and standard tissue attenuation ranges: fat -190– -30 HU; skeletal muscle -29–150 HU.Mean±sdpercentage intramuscular fat was higher in the patient group (6.7±3.5%versus4.3±1.2%, p = 0.03). Both percentage intramuscular fat and skeletal muscle attenuation were associated with physical activity level, exercise capacity and type I fibre proportion, independent of age, mid-thigh cross-sectional area and quadriceps strength. Combined with transfer factor of the lung for carbon monoxide, these variables could identify >80% of patients with fibre type shift with >65% specificity (area under the curve 0.83, 95% CI 0.72–0.95).Skeletal muscle adiposity assessed by computed tomography reflects multiple aspects of COPD related muscle dysfunction and may help to identify patients for trials of interventions targeted at specific muscle phenotypes.


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